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General NPI Number Information
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NPI Number | 1447409206
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Entity Type | Individual
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Provider Name | KERRI LEE ELLIS A.R.N.P.
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Gender | Female
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Dates
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Enumeration Date | 09/16/2008
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | 103 E MAIN ST
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City | BEGGS
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State | OK
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Zip | 74421
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Country | US
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Telephone | 918-267-7000
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Fax | 918-267-7077
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Provider Business Mailing Address
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Address Line | PO BOX 478 103 E MAIN ST
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City | BEGGS
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State | OK
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Zip | 74421-0478
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Country | US
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Telephone | 918-367-0010
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Fax | 918-703-4713
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53535
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License Number State | OK
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